{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T03:39:05Z","timestamp":1781753945681,"version":"3.54.5"},"reference-count":71,"publisher":"Deutscher Arzte-Verlag GmbH","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"DOI":"10.3238\/arztebl.m2025.0215","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T08:13:03Z","timestamp":1772093583000},"source":"Crossref","is-referenced-by-count":1,"title":["Perioperative risk assessment and therapeutic consequences"],"prefix":"10.3238","author":[{"given":"Vera von","family":"Dossow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Lurati","family":"Buse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tau","family":"Hartikainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Mirus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes T.","family":"Neumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11437","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"10.3238\/arztebl.m2025.0215_ref1","unstructured":"https:\/\/de.statista.com\/statistik\/daten\/studie\/76889\/umfrage\/operationen-und-behandlungsmassnahmen-in-deutschen-krankenhaeusern\/ (last accessed on 8 February 2026)."},{"key":"10.3238\/arztebl.m2025.0215_ref2","unstructured":"www.gesundheitsatlas-deutschland.de\/erkrankung\/herzinsuffizienz? (last accessed on on 8 February 2026)."},{"key":"10.3238\/arztebl.m2025.0215_ref3","unstructured":"https:\/\/de.statista.com\/statistik\/daten\/studie\/240\/umfrage\/verteilung-der-sterbefaelle-nach-todesursachen. 2023 (last accessed on 8 February 2026)."},{"key":"10.3238\/arztebl.m2025.0215_ref4","unstructured":"Holstiege J, Akmatov MK, Steffen A, B\u00e4tzing J: Pr\u00e4valenz der Herzinsuffizienz – bundesweite Trends, regionale Variationen und h\u00e4ufige Komorbidit\u00e4ten. Zentralinstitut f\u00fcr die kassen\u00e4rztliche Versorgung in Deutschland (Zi). Versorgungsatlas-Bericht Nr 18\/09. 2018."},{"key":"10.3238\/arztebl.m2025.0215_ref5","doi-asserted-by":"crossref","unstructured":"Hammill BG, Curtis LH, Bennett-Guerrero E, et al.: Impact of heart failure on patients undergoing major noncardiac surgery. Anesthesiology 2008; 108: 559–67.","DOI":"10.1097\/ALN.0b013e31816725ef"},{"key":"10.3238\/arztebl.m2025.0215_ref6","doi-asserted-by":"crossref","unstructured":"Gualandro DM, Puelacher C, Chew MS, et al.: Acute heart failure after non-cardiac surgery: Incidence, phenotypes, determinants and outcomes. Eur J Heart Fail 2023; 25: 347–57.","DOI":"10.1002\/ejhf.2773"},{"key":"10.3238\/arztebl.m2025.0215_ref7","unstructured":"McDonagh TA, Metra M, Adamo M, et al.: 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021; 42: 3599–726."},{"key":"10.3238\/arztebl.m2025.0215_ref8","doi-asserted-by":"crossref","unstructured":"Rywik TM, Doryńska A, Wiśniewska A, et al.: Epidemiology and clinical characteristics of hospitalized patients with heart failure with reduced, mildly reduced, and preserved ejection fraction. Pol Arch Intern Med 2022; 132: 16227.","DOI":"10.20452\/pamw.16227"},{"key":"10.3238\/arztebl.m2025.0215_ref9","doi-asserted-by":"crossref","unstructured":"Kapelios CJ, Shahim B, Lund LH, Savarese G: Epidemiology, clinical characteristics and cause-specific outcomes in heart failure with preserved ejection fraction: Card Fail Rev 2023; 9: e14.","DOI":"10.15420\/cfr.2023.03"},{"key":"10.3238\/arztebl.m2025.0215_ref10","doi-asserted-by":"crossref","unstructured":"Huang YY, Chen L, Wright JD: Comparison of perioperative outcomes in heart failure patients with reduced versus preserved ejection fraction after noncardiac surgery. Ann Surg 2022; 275: 807–15.","DOI":"10.1097\/SLA.0000000000004044"},{"key":"10.3238\/arztebl.m2025.0215_ref11","doi-asserted-by":"crossref","unstructured":"Smilowitz NR, Banco D, Katz SD, Beckman JA, Berger JS: Association between heart failure and perioperative outcomes in patients undergoing non-cardiac surgery. Eur Heart J Qual Care Clin Outcomes 2021; 7: 68–75.","DOI":"10.1093\/ehjqcco\/qcz066"},{"key":"10.3238\/arztebl.m2025.0215_ref12","doi-asserted-by":"crossref","unstructured":"Thompson A, Fleischmann KE, Smilowitz NR, et al.: 2024 AHA\/ACC\/ACS\/ASNC\/HRS\/SCA\/SCCT\/SCMR\/SVM Guideline for perioperative cardiovascular management for noncardiac surgery: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2024; 150: e351–e442.","DOI":"10.1161\/CIR.0000000000001298"},{"key":"10.3238\/arztebl.m2025.0215_ref13","unstructured":"Halvorsen S, Mehilli J, Cassese S, et al.: 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery. Eur Heart J 2022; 43: 3826–924."},{"key":"10.3238\/arztebl.m2025.0215_ref14","doi-asserted-by":"crossref","unstructured":"Lurati Buse G, Bollen Pinto B, Abelha F, et al.: ESAIC focused guideline for the use of cardiac biomarkers in perioperative risk evaluation. Eur J Anaesthesiol 2023; 40: 888–927.","DOI":"10.1097\/EJA.0000000000001865"},{"key":"10.3238\/arztebl.m2025.0215_ref15","doi-asserted-by":"crossref","unstructured":"Botto F, Alonso-Coello P, Chan MT, et al.: Myocardial injury after noncardiac surgery: A large, international, prospective cohort study establishing diagnostic criteria, characteristics, predictors, and 30-day outcomes. Anesthesiology 2014; 120: 564–78.","DOI":"10.1097\/ALN.0000000000000113"},{"key":"10.3238\/arztebl.m2025.0215_ref16","doi-asserted-by":"crossref","unstructured":"Oh AR, Park J, Shin SJ, et al.: Prediction model for myocardial injury after non-cardiac surgery using machine learning. Sci Rep 2023; 13: 1475.","DOI":"10.1038\/s41598-023-43067-0"},{"key":"10.3238\/arztebl.m2025.0215_ref17","doi-asserted-by":"crossref","unstructured":"Schmidt G, Frieling N, Schneck E, et al.: Preoperative routine measurement of NT-proBNP predicts postoperative morbidity after non-cardiac surgery with intermediate or high surgical risk: An observational study. BMC Anesthesiol 2024; 24: 113.","DOI":"10.1186\/s12871-024-02488-8"},{"key":"10.3238\/arztebl.m2025.0215_ref18","doi-asserted-by":"crossref","unstructured":"Z\u00f6llner C: [Preoperative evaluation of adult patients before elective, non-cardiothoracic surgery: A joint recommendation of the German Society for Anesthesiology and Intensive Care Medicine, the German Society for Surgery and the German Society for Internal Medicine]. Anaesthesiologie 2024; 73: 294–323.","DOI":"10.1007\/s00101-024-01408-2"},{"key":"10.3238\/arztebl.m2025.0215_ref19","doi-asserted-by":"crossref","unstructured":"Puelacher C, Mueller C: Response by Puelacher and Mueller to letters regarding article, „perioperative myocardial injury after noncardiac surgery: Incidence, mortality, and characterization“. Circulation 2018; 138: 1077–8.","DOI":"10.1161\/CIRCULATIONAHA.118.036017"},{"key":"10.3238\/arztebl.m2025.0215_ref20","doi-asserted-by":"crossref","unstructured":"Puelacher C, Gualandro DM, Glarner N, et al.: Long-term outcomes of perioperative myocardial infarction\/injury after non-cardiac surgery. Eur Heart J 2023; 44: 1690–701.","DOI":"10.1093\/eurheartj\/ehad655.2649"},{"key":"10.3238\/arztebl.m2025.0215_ref21","doi-asserted-by":"crossref","unstructured":"Chew MS, Puelacher C, Patel A, et al.: Identification of myocardial injury using perioperative troponin surveillance in major noncardiac surgery and net benefit over the Revised Cardiac Risk Index. Br J Anaesth 2022; 128: 26–36.","DOI":"10.1016\/j.bja.2021.10.006"},{"key":"10.3238\/arztebl.m2025.0215_ref22","unstructured":"Devereaux PJ, Biccard BM, Sigamani A, et al.: Association of postoperative high-sensitivity troponin levels with myocardial injury and 30-day mortality among patients undergoing noncardiac surgery. JAMA 2017; 317: 1642–51."},{"key":"10.3238\/arztebl.m2025.0215_ref23","doi-asserted-by":"crossref","unstructured":"Schweizer R, Jacquet-Lagreze M, Fellahi JL: Implementation of 2022 ESC guidelines for cardiovascular assessment before non-cardiac surgery: Major concerns to meet in the near future! Eur J Anaesthesiol 2023; 40: 385–6.","DOI":"10.1097\/EJA.0000000000001835"},{"key":"10.3238\/arztebl.m2025.0215_ref24","doi-asserted-by":"crossref","unstructured":"Kaplinsky E: DAPA-HF trial: Dapagliflozin evolves from a glucose-lowering agent to a therapy for heart failure. Drugs Context 2020; 9: 2019–11–3.","DOI":"10.7573\/dic.2019-11-3"},{"key":"10.3238\/arztebl.m2025.0215_ref25","doi-asserted-by":"crossref","unstructured":"Packer M, Butler J, Zannad F, et al.: Effect of empagliflozin on worsening heart failure events in patients with heart failure and preserved ejection fraction: EMPEROR-preserved trial. Circulation 2021; 144: 1284–94.","DOI":"10.1161\/CIRCULATIONAHA.121.056824"},{"key":"10.3238\/arztebl.m2025.0215_ref26","unstructured":"McMurray JJV, Solomon SD, Inzucchi SE, et al.: Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med 2019; 381: 1995–2008."},{"key":"10.3238\/arztebl.m2025.0215_ref27","unstructured":"McDonagh TA, Metra M, Adamo M, et al.: 2023 focused update of the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2023; 44: 3627–39."},{"key":"10.3238\/arztebl.m2025.0215_ref28","unstructured":"Solomon SD, McMurray JJV, Claggett B, et al.: Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med 2022; 387: 1089–98."},{"key":"10.3238\/arztebl.m2025.0215_ref29","unstructured":"Malgie J, Wilde MI, Clephas PRD, et al.: Contemporary guideline-directed medical therapy in de novo, chronic, and worsening heart failure patients: First data from the TITRATE-HF study. Eur J Heart Fail 2024; 26: 1549–60."},{"key":"10.3238\/arztebl.m2025.0215_ref30","doi-asserted-by":"crossref","unstructured":"Roshanov PS, Rochwerg B, Patel A, et al.: Withholding versus continuing angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers before noncardiac surgery: An analysis of the vascular events in noncardiac surgery patIents cOhort evaluatioN prospective cohort. Anesthesiology 2017; 126: 16–27.","DOI":"10.1097\/ALN.0000000000001404"},{"key":"10.3238\/arztebl.m2025.0215_ref31","unstructured":"Legrand M, Falcone J, Cholley B, et al.: Continuation vs discontinuation of renin-angiotensin system inhibitors before major noncardiac surgery: The stop-or-not randomized clinical Trial. JAMA 2024; 332: 970–8."},{"key":"10.3238\/arztebl.m2025.0215_ref32","unstructured":"Ackland GL, Patel A, Abbott TEF, et al.: Discontinuation vs. continuation of renin-angiotensin system inhibition before non-cardiac surgery: The SPACE trial. Eur Heart J 2024; 45: 1146–55."},{"key":"10.3238\/arztebl.m2025.0215_ref33","doi-asserted-by":"crossref","unstructured":"Musso G, Saba F, Cassader M, Gambino R: Diabetic ketoacidosis with SGLT2 inhibitors. BMJ 2020; 371: m4147.","DOI":"10.1136\/bmj.m4147"},{"key":"10.3238\/arztebl.m2025.0215_ref34","doi-asserted-by":"crossref","unstructured":"Colacci M, Fralick J, Odutayo A, Fralick M: Sodium-glucose cotransporter-2 inhibitors and risk of diabetic ketoacidosis among adults with type 2 diabetes: A systematic review and meta-analysis. Can J Diabetes 2022; 46: 10–5.e2.","DOI":"10.1016\/j.jcjd.2021.04.006"},{"key":"10.3238\/arztebl.m2025.0215_ref35","doi-asserted-by":"crossref","unstructured":"Mehta PB, Robinson A, Burkhardt D, Rushakoff RJ: Inpatient perioperative euglycemic diabetic ketoacidosis due to sodium-glucose cotransporter-2 inhibitors—lessons from a case series and strategies to decrease incidence. Endocr Pract 2022; 28: 884–8.","DOI":"10.1016\/j.eprac.2022.06.006"},{"key":"10.3238\/arztebl.m2025.0215_ref36","doi-asserted-by":"crossref","unstructured":"Shi Q, Nong K, Vandvik PO, et al.: Benefits and harms of drug treatment for type 2 diabetes: Systematic review and network meta-analysis of randomised controlled trials. BMJ 2023; 381: e074068.","DOI":"10.1136\/bmj-2022-074068"},{"key":"10.3238\/arztebl.m2025.0215_ref37","doi-asserted-by":"crossref","unstructured":"Thiruvenkatarajan V, Meyer EJ, Nanjappa N, Van Wijk RM, Jesudason D: Perioperative diabetic ketoacidosis associated with sodium-glucose co-transporter-2 inhibitors: A systematic review. Br J Anaesth 2019; 123: 27–36.","DOI":"10.1016\/j.bja.2019.03.028"},{"key":"10.3238\/arztebl.m2025.0215_ref38","doi-asserted-by":"crossref","unstructured":"Seki H, Kuratani N, Shiga T, et al.: Incidence of sodium-glucose cotransporter-2 inhibitor-associated perioperative ketoacidosis in surgical patients: A prospective cohort study. J Anesth 2024; 38: 464–74.","DOI":"10.1007\/s00540-024-03335-3"},{"key":"10.3238\/arztebl.m2025.0215_ref39","doi-asserted-by":"crossref","unstructured":"Dixit AA, Bateman BT, Hawn MT, Odden MC, Sun EC: Preoperative SGLT2 inhibitor use and postoperative diabetic ketoacidosis. JAMA Surg 2025; 160: 423–30.","DOI":"10.1001\/jamasurg.2024.7082"},{"key":"10.3238\/arztebl.m2025.0215_ref40","doi-asserted-by":"crossref","unstructured":"Tenge T, Roth S, Ahrens E, et al.: Preoperative SGLT-2 inhibitor use and risk of adverse postoperative events: A single-centre retrospective observational study. Br J Anaesth 2025; 134: 1214–7.","DOI":"10.1016\/j.bja.2024.12.024"},{"key":"10.3238\/arztebl.m2025.0215_ref41","doi-asserted-by":"crossref","unstructured":"Melloul E, Lassen K, Roulin D,et al.: Guidelines for perioperative care for pancreatoduodenectomy: Enhanced recovery after surgery (ERAS) recommendations 2019. World J Surg 2020; 44: 2056–84.","DOI":"10.1007\/s00268-020-05462-w"},{"key":"10.3238\/arztebl.m2025.0215_ref42","unstructured":"Schwenk W: Optimized perioperative management (fast-track, ERAS) to enhance postoperative recovery in elective colorectal surgery. GMS Hyg Infect Control 2022; 17: Doc10."},{"key":"10.3238\/arztebl.m2025.0215_ref43","doi-asserted-by":"crossref","unstructured":"Saugel B, Fletcher N, Gan TJ, Grocott MPW, Myles PS, Sessler DI: Perioperative quality initiative (POQI) international consensus statement on perioperative arterial pressure management. Br J Anaesth 2024; 133: 264–76.","DOI":"10.1016\/j.bja.2024.04.046"},{"key":"10.3238\/arztebl.m2025.0215_ref44","doi-asserted-by":"crossref","unstructured":"Saugel B, Annecke T, Bein B, et al.: Intraoperative haemodynamic monitoring and management of adults having non-cardiac surgery: Guidelines of the German Society of Anaesthesiology and Intensive Care Medicine in collaboration with the German Association of the Scientific Medical Societies. J Clin Monit Comput 2024; 38: 945–59.","DOI":"10.1007\/s10877-024-01132-7"},{"key":"10.3238\/arztebl.m2025.0215_ref45","doi-asserted-by":"crossref","unstructured":"Marx G, Schindler AW, Mosch C, et al.: Intravascular volume therapy in adults: Guidelines from the Association of the Scientific Medical Societies in Germany. Eur J Anaesthesiol 2016; 33: 488–521.","DOI":"10.1097\/EJA.0000000000000447"},{"key":"10.3238\/arztebl.m2025.0215_ref46","doi-asserted-by":"crossref","unstructured":"Patel AY, Eagle KA, Vaishnava P: Cardiac risk of noncardiac surgery. J Am Coll Cardiol 2015; 66: 2140–8.","DOI":"10.1016\/j.jacc.2015.09.026"},{"key":"10.3238\/arztebl.m2025.0215_ref47","unstructured":"Halvorsen S, Mehilli J, Cassese S, et al.: 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery. Eur Heart J 2022; 43: 3826–924."},{"key":"10.3238\/arztebl.m2025.0215_ref48","doi-asserted-by":"crossref","unstructured":"Gawande AA, Kwaan MR, Regenbogen SE, Lipsitz SA, Zinner MJ: An Apgar score for surgery. J Am Coll Surg 2007; 204: 201–8.","DOI":"10.1016\/j.jamcollsurg.2006.11.011"},{"key":"10.3238\/arztebl.m2025.0215_ref49","doi-asserted-by":"crossref","unstructured":"de la Espriella R, Cobo M, Santas E, et al.: Assessment of filling pressures and fluid overload in heart failure: An updated perspective. Rev Esp Cardiol (Engl Ed) 2023; 76: 47–57.","DOI":"10.1016\/j.rec.2022.07.009"},{"key":"10.3238\/arztebl.m2025.0215_ref50","doi-asserted-by":"crossref","unstructured":"Oh TK, Song IA, Do SH, Jheon S, Lim C: Association of perioperative weight-based fluid balance with 30-day mortality and acute kidney injury among patients in the surgical intensive care unit. J Anesth 2019; 33: 354–63.","DOI":"10.1007\/s00540-019-02630-8"},{"key":"10.3238\/arztebl.m2025.0215_ref51","doi-asserted-by":"crossref","unstructured":"Smilowitz NR, Redel-Traub G, Hausvater A, et al.: Myocardial injury after noncardiac surgery: A systematic review and meta-analysis. Cardiol Rev 2019; 27: 267–73.","DOI":"10.1097\/CRD.0000000000000254"},{"key":"10.3238\/arztebl.m2025.0215_ref52","doi-asserted-by":"crossref","unstructured":"Mudumbai SC, Takemoto S, Cason BA, Au S, Upadhyay A, Wallace AW: Thirty-day mortality risk associated with the postoperative nonresumption of angiotensin-converting enzyme inhibitors: A retrospective study of the Veterans Affairs Healthcare System. J Hosp Med 2014; 9: 289–96.","DOI":"10.1002\/jhm.2182"},{"key":"10.3238\/arztebl.m2025.0215_ref53","doi-asserted-by":"crossref","unstructured":"Lee SM, Takemoto S, Wallace AW: Association between withholding angiotensin receptor blockers in the early postoperative period and 30-day mortality: A cohort study of the veterans affairs healthcare system. Anesthesiology 2015; 123: 288–306.","DOI":"10.1097\/ALN.0000000000000739"},{"key":"10.3238\/arztebl.m2025.0215_ref54","doi-asserted-by":"crossref","unstructured":"Murphy SP, Ibrahim NE, Januzzi JL, Jr.: Heart failure with reduced ejection fraction: A Review. JAMA 2020; 324: 488–504.","DOI":"10.1001\/jama.2020.10262"},{"key":"10.3238\/arztebl.m2025.0215_ref55","doi-asserted-by":"crossref","unstructured":"Zannad F, Ferreira JP, Pocock SJ, et al: SGLT2 inhibitors in patients with heart failure with reduced ejection fraction: A meta-analysis of the EMPEROR-reduced and DAPA-HF trials. Lancet 2020; 396: 819–29.","DOI":"10.1016\/S0140-6736(20)31824-9"},{"key":"10.3238\/arztebl.m2025.0215_ref56","unstructured":"Anker SD, Butler J, Filippatos G, Ferreira JP, et al.: Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med 2021; 385: 1451–61."},{"key":"10.3238\/arztebl.m2025.0215_ref57","unstructured":"McDonagh TA, Metra M, Adamo M, et al.: 2023 focused update of the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2023; 44: 3627–39."},{"key":"10.3238\/arztebl.m2025.0215_ref58","unstructured":"McDonagh TA, Metra M, Adamo M, et al.: 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021; 42: 3599–726."},{"key":"10.3238\/arztebl.m2025.0215_ref59","unstructured":"Bakker WM, Heerspink HJL, Berger SP, et al.: Rationale and design of the renal lifecycle trial assessing the effect of dapagliflozin on cardiorenal outcomes in severe chronic kidney disease. Nephrol Dial Transplant 2025; 40: 1746–55."},{"key":"10.3238\/arztebl.m2025.0215_ref60","doi-asserted-by":"crossref","unstructured":"Faris R, Flather M, Purcell H, Henein M, Poole-Wilson P, Coats A: Current evidence supporting the role of diuretics in heart failure: A meta analysis of randomised controlled trials. Int J Cardiol 2002; 82: 149–58.","DOI":"10.1016\/S0167-5273(01)00600-3"},{"key":"10.3238\/arztebl.m2025.0215_ref61","doi-asserted-by":"crossref","unstructured":"Cleland JG, Tendera M, Adamus J, Freemantle N, Polonski L, Taylor J: The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J 2006; 27: 2338–45.","DOI":"10.1093\/eurheartj\/ehl250"},{"key":"10.3238\/arztebl.m2025.0215_ref62","doi-asserted-by":"crossref","unstructured":"Granger CB, McMurray JJ, Yusuf S, et al.: Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: The CHARM-alternative trial. Lancet 2003; 362: 772–6.","DOI":"10.1016\/S0140-6736(03)14284-5"},{"key":"10.3238\/arztebl.m2025.0215_ref63","doi-asserted-by":"crossref","unstructured":"Solomon SD, Vaduganathan M, L Claggett B, et al.: Sacubitril\/valsartan across the spectrum of ejection fraction in heart failure. Circulation 2020; 141: 352–61.","DOI":"10.1161\/CIRCULATIONAHA.119.044586"},{"key":"10.3238\/arztebl.m2025.0215_ref64","doi-asserted-by":"crossref","unstructured":"Pitt B, Pfeffer MA, Assmann SF, et al.: Spironolactone for heart failure with preserved ejection fraction. N Engl J Med 2014; 370: 1383–92.","DOI":"10.1056\/NEJMoa1313731"},{"key":"10.3238\/arztebl.m2025.0215_ref65","doi-asserted-by":"crossref","unstructured":"Cleland JGF, Bunting KV, Flather MD, et al.: Beta-blockers for heart failure with reduced, mid-range, and preserved ejection fraction: An individual patient-level analysis of double-blind randomized trials. Eur Heart J 2018; 39: 26–35.","DOI":"10.1093\/eurheartj\/ehx564"},{"key":"10.3238\/arztebl.m2025.0215_ref66","doi-asserted-by":"crossref","unstructured":"Garg R, Yusuf S: Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials. JAMA 1995; 273: 1450–6.","DOI":"10.1001\/jama.1995.03520420066040"},{"key":"10.3238\/arztebl.m2025.0215_ref67","doi-asserted-by":"crossref","unstructured":"McMurray JJ, Packer M, Desai AS, et al.: Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med 2014; 371: 993–1004.","DOI":"10.1056\/NEJMoa1409077"},{"key":"10.3238\/arztebl.m2025.0215_ref68","doi-asserted-by":"crossref","unstructured":"Zannad F, McMurray JJ, Krum H, et al.: Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med 2011; 364: 11–21.","DOI":"10.1056\/NEJMoa1009492"},{"key":"10.3238\/arztebl.m2025.0215_ref69","doi-asserted-by":"crossref","unstructured":"Packer M, Fowler MB, Roecker EB, et al.: Effect of carvedilol on the morbidity of patients with severe chronic heart failure: Results of the carvedilol prospective randomized cumulative survival (COPERNICUS) study. Circulation 2002; 106: 2194–9.","DOI":"10.1161\/01.CIR.0000035653.72855.BF"},{"key":"10.3238\/arztebl.m2025.0215_ref70","doi-asserted-by":"crossref","unstructured":"Flather MD, Shibata MC, Coats AJ,et al.: Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J 2005; 26: 215–25.","DOI":"10.1093\/eurheartj\/ehi115"},{"key":"10.3238\/arztebl.m2025.0215_ref71","unstructured":"Packer M, Anker SD, Butler J, et al.: Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med 2020; 383: 1413–24."}],"container-title":["Deutsches \u00c4rzteblatt international"],"original-title":[],"link":[{"URL":"https:\/\/www.aerzteblatt.de\/10.3238\/arztebl.m2025.0215","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T08:13:46Z","timestamp":1772093626000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.aerzteblatt.de\/10.3238\/arztebl.m2025.0215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,6]]},"references-count":71,"URL":"https:\/\/doi.org\/10.3238\/arztebl.m2025.0215","relation":{},"ISSN":["1866-0452"],"issn-type":[{"value":"1866-0452","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,6]]}}}